Scoliosis ≠ Disability in Adulthood

I have seen the fear in parents’ eyes after they have been told that their child has mild scoliosis. That fear is also inevitably passed on to the innocent child as the years go by. So here is the question: are teens diagnosed with adolescent idiopathic scoliosis (AIS) doomed to have back pain in their adulthood? The basic answer is no, they are not doomed!

A study based on 363 teens with AIS between 1935 and 1975 who had available original radiographs found that after 20 years, their back condition was not so bad after all.

Those with AIS of curves between 20° and 55° were compared to age- and sex-matched controls with regard to back pain, radicular symptoms, and disability.

Result #1: 65% of those with scoliosis had some form of back pain versus only 32% of those without… so twice as likely to have back pain.

Result #2: Average back pain was rated higher for those who had scoliosis HOWEVER with a mean pain score of 3 in those with scoliosis and 2 in those without! One point is hardly something to worry about.

Result #3: 34% of those with scoliosis had radicular symptoms versus 16% of those without.

Result #4: None of the 34 patients with scoliosis underwent surgery for back pain however one patient in the control group did.

Result #5: But most importantly, there were no differences between those with scoliosis and those without with respect to their perceived disability.

Clinical Relevance: As PTs we must make sure that teens diagnosed with scoliosis (and their parents) do not paint a doom and gloom picture of their future.

Although those with scoliosis have greater frequency of spinal pain, the degree of pain is not that different from the general population and there is no difference in their long-term function.

It is essential for us to share these facts with our patients as they may avoid certain movements, activities and hobbies believing that they must “save their spine”.

Reference: Cordover A et al Natural history of adolescent thoracolumbar and lumbar idiopathic scoliosis into adulthood. J Spinal Disord. 1997 Jun;10(3):193-6.